Dr Sanjiva Wijesinhe reports on Sri Lanka’s traditional medicine.
As the 20th century draws to a close, we find an increasingly health conscious western world searching for effective alternatives to the spiralling costs and unhealthy side effects of modern medicine.
In Sri Lanka, on the other hand, we have had for the last couple of millenia a “Userfriendly” form of traditional medicine called Ayurveda that is still practised throughout the country. Over 75 percent of the island’s population depends on it for the simple reason that they have access to little else, but it is not uncommon to find even sophisticated western-educated city dwellers turning to ayurveda.
There are diabetics in Colombo who daily take their insulin injections on the one hand while drinking a glass of Karavila extract with the other. Similarly, ayurvedic herbal oils are almost universally used in this country to ease the inevitable muscle and joint stiffness felt after the orthopaedic surgeon removes one’s plaster cast following the healing of a fractured bone.
What is exactly ayurveda?
It is an ancient system of medicine which developed in the Indian subcontinent centuries before the so-called “father of medicine”, Hippocrates, was born in Europe. The name comes from two conjoined Sanskrit words ayuh (life) veda (science or knowledge). It is basically a science of healthy living, and has two aims:
(a) to preserve health
(b) to cure the body when afflicted by disease.
One of the fundamental beliefs of ayurveda is the doctrine of Tri Dasha, or the Three Vital Forces. These three, vayu, pita; and kapha have been inaccurately translated into English as Wind, Bile and Phlegm, thereby being confused with the bodily Humours of the Greek philosophers.
A more correct interpretation of vayu is the phenomenon of energy transmission within the body; in modern medical terms, nerve impulses, muscle contraction and hormonal activity. Pitta does not refer simply_ to bile or even the “Chollericke humor” mentioned by Shakespeare; rather, it signifies the whole scope of metabolism and internal heat production. Kapha means mucus, often described as “The Protective Fluid”. The relatively modern concept of mucus as an antibody containing liquid which coats and protects internal linings of the body, seems to fit in with ayurvedic thinking.
When the three doshas are in normal equilibrium, the body is in good health. When this equilibrium is disturbed, when some derangement occurs in the balance of these complementary forces, then illness is the result.
As far as its preventive aspects are concerned, ayurveda recommends codes for healthy living including dietary and socio-cultural norms. Certain foods are considered good, while the partaking of others (such as red meats is discouraged.
Vegetarianism and the consumption of dairy products such as milk and curd are advocated. Drinking alcohol and smoking are frowned upon. Basic practices of hygiene such as drinking boiled water and washing one’s hands before touching foods are fundamental.
Ayurvedic practioners have their own methods of diagnosing disease, by relying on the five senses. Interrogation of the patient and his family, inspection, palpation, auscultation, percussion and observation of smells form the basis of clinical examination; supplementary laboratoy tests and X-ray play no parts in ayurvedic diagnosis.
Ayurvedists maintain that they study the patient as a whole with the object of restoring normality. while western medicine specializes in merely attacking the disease. there is a saying that western medicine classifies germs and attempts to destroy them – while ayurveda classifies human beings and attempts to save them. Ayurvedic treatment is claimed to be non-toxic, and is geared to restoring the body’s natural resistance and immunity.
The first line of treatment for many diseases is Pancha Karma or five-pronged evacuative therapy. This is designed to rid the body of toxins and is achieved by special diets and herbal decoctions.
The preparation of ayurvedic medications is usually a cumbersome and tedious process. Metals, for example, are subjected to high temperatures before being ground with herbal juices in a pestle for a prescribed period of time. Herbal extracts are made by boiling parts of plants and then allowing the resulting liquid to simmer until it is reduced to a fraction of its original volume. Ghee forms the basis for many preparations. Besides decoctions, wines, pills and powders for internal use, ayurveda also uses poultices, pastes, ointments and oils for external application.
The potential of ayurveda in today’s world is underlined by a multi-million dollar joint venture recently undertaken by scientists from Sri Jayewardenepura University of Sri Lanka and the University of Utrecht in the Netherlands. Planned over the next five years, the project has as its objective the collecting of information and the scientific study of ayurvedic remedies in Sri Lanka. Already over 150 species of local herbs and plants used in the preparation of ayurvedic medicines have been studied.
Researchers are collecting data from ayurvedic practioners throughout the country, some of whose knowledge has been acquired by oral transm1ss10n from father to son over the centuries. Information is also being obtained by perusing ancient hand-written o/a leaf manuscripts and yellowed tomes, long hidden in private libraries.
Dried herbs and grain on display at an ayurvedic shop.
Other researchers are analyzing the pharmacological actions of these remedies in a modern fully equipped laboratory which has been donated by the Dutch government to the Chemistry Department at Sri Jayewardenepura University.
Among the plants thus far analysed are kohomba (margosa or azadirachta) which is useful for certain skin diseases. It has definite antiseptic properties and is the active ingredient in a popular brand of toilet soap. Another is gotukola (sentela asiatica) known as a remedy for hay fever and catarrh. It has a high content of vitamin A and folic aicd. It is commercially available now on Colombo’s supermarket shelves as a herbal tea and in capsule form.
The roots of the katukarosana (picrorhiza kurroa) plant have been used from early times to make a preparation for blood purification; it is also employed for cough remedies.
The Dutch Sri Lankan collaboration aims to provide a scientific basis for the use of the old Ayurvedic preparations and perhaps for the standardisation of these remedies. Their efficacy however, cannot be doubted after all, it must be remembered that for generations thousands of Sri Lankans have been using the age-old remedies and obtaining relief from their ailments.
The modern drug Digoxin, used by cardiologists the world over to regulate the action of the heart is simply a purified, standardize extract of the foxglove plant Similarly, antimitotic drug, Vincristine and Vinblastine which in the present century started a revolution in the treatment of leukemias and cancers, are derived from the rosy periwinkle
plant which grows wild in graveyards all over this country.
By probing the mysteries of ayurveda today, who knows what new drugs will be revealed for the use of the 21st cen ury physicians?
Herbs are ground in a pestle.
